Investigating the Relationship between Fingerprint Pattern and Development of Oral Squamous Cell Carcinoma

Statement of the Problem: Oral squamous cell carcinoma (OSCC) constitutes more than 90% of oral malignancies. The main risk factors of OSCC include cigarette smoking and alcohol. However, since not all smokers or alcohol drinkers develop this disease, other factors have also been suggested including genetic characteristics of every person to be implicated in the probability of developing OSCC. Purpose: Our aim in this study is to investigate the possible relationship between fingerprint patterns and the probability of developing OSCC. Materials and Method: In a cross sectional study, we had 140 patients in 2 groups as OSCC and cancer free. Fingerprints were recorded by fingerprint scanner device. The fingerprint patterns were categorized into three major groups and four subgroups. Groups were tested by chi-square. Results: The relationship between the main fingerprint patterns and incidence of OSCC became significant (p= 0.037). The frequency of the main pattern of Arch was significantly higher in the experimental group than in the control group (p< 0.05). Considering the main patterns of Loop and Whorl, no significant difference existed between the two groups. Furthermore, the frequency of subtype patterns of Double Whorl and Central Pocket Whorl was significantly higher in the control group than in the experimental group (p< 0.05). Conclusion: Since dermatoglyphics is contingent upon genetic variations, fingerprint can be used for investigating the susceptibility of people in developing different diseases, though further studies are required in this regard. This method is in no way a substitute for gold standard methods for diagnosis.


Introduction
Oral cancer is the sixth common cancer in the world and one of the 10 common causes of mortality. Oral squamous cell carcinoma (OSCC) constitutes more than 90% of oral malignancies [1][2]. Its etiology is multifactorial and there is no single factor known for its development, whereby both genetic and epigenetic factors can be involved. The main risk factors of OSCC include cigarette smoking and alcohol. However, since not all smokers or alcohol drinkers develop this disease, other factors have also been suggested including genetic characteristics of every person to be implicated in the probability of developing OSCC [3][4][5][6][7].
Dermatoglyphics studies the skin lines present in the palm and sole as well as tip of the fingers and toes [8][9].
A multi-gene system controls the creation and development of skin lines. Since the genes participating in controlling skin lines have not been found completely, and considering the concurrency of formation of skin lines with that of many important tissues of the body, it is possible that the dermatoglyphic patterns could highlight the genetic makeup of a person and the possibility of developing some diseases with a genetic basis. Extensive research has examined the skin lines in patients with tuberculosis, insulin-dependent diabetes, breast cancer, asthma, leukemia, hypothyroidism, coronary artery disease, schizophrenia, Down syndrome, Klein Falter syndrome, Turner syndrome, Trisomy 18, Alzheimer's, rubella, rheumatoid arthritis, and psychological disease. In many of these studies, a significant difference has been reported between patient and control groups. In different areas of dentistry, dermatoglyphic patterns have been investigated considering the shared origin of oral tissues and skin lines, being the ectoderm layer, as well as the concurrency of the formation of oral tissues and these lines beginning from the fourth embryonic week up to 13th embryonic week. The relationship between skin lines and different diseases has been investigated including dental caries, bruxism, periodontal diseases, cleft lips, oral submucosal fibrosis, oral leukoplakia, mesiodens and skeletal malocclusions [8][9][10][11][12][13][14][15][16].
Our aim is to investigate the possible relationship between fingerprint patterns and the probability of developing OSCC.  In order to compare the frequency of the fingerprints in the experimental and control groups, chi-square test was used. Next, through calculating the odds ratio related to each of the fingerprint patterns in both patient and healthy subjects, and if confidence interval of 95% of odds ratio did not confirm the assumption of equality of these ratios, a significant difference about that type of fingerprint was considered between the healthy and patient groups. All the above analyses were performed using SPSS Software (Statistical Package for Social Science) version 25. A p Value less than 0.05 were considered statistically significant.

Results
In this study, with regard to the inclusion and exclusion criteria, 70 patients with OSCC referring to cancer Institute of Imam Khomeini Hospital, Tehran were included in the experimental group consisting of 36 males and 34 squamous cell carcinoma of buccal mucosa and gingiva,  Table 2).
The frequency of the major types of fingerprint patterns for every finger in both the experimental and control groups has been reported in Tables 3a and 3b   and ring finger of the right hand (odds ratio=0.2, p< 0.05) and little finger of the right hand (odds ratio=0.57, p< 0.05) has been significantly higher in the control group than in the experimental group. (Table 3a, Table   3b, Table 4a, Table 4b).

Discussion
Regarding the increasing rate of alcohol and cigarette consumption in today's societies, the prevalence of oral cancer is growing and may change into a major public health concern [3,13].
Some studies have reported that hereditary factors are also involved in incidence of OSCC, as it has been observed that individuals whose first-degree relatives had OSCC are at higher risk of developing the cancer.
Moreover, it has been found that not all cigarette smok- Since genetics plays a significant role in all cancers, in different studies, the relationship between qualitative and quantitative analyses of fingerprint and cancers such as thyroid, breast, prostate and cervix has been investigated, in many of which a significant relationship has been found [3,13,19]. The present study deals with investigating a possible relationship between fingerprint patterns and the probability of developing OSCC, so that through dermatoglyphic as a facility, the individuals who are genetically highly susceptible to developing OSCC would be identified.
The differentiating point of this study is consideration and comparison of subtypes of fingerprint and its evaluation in all fingers. In some studies, the frequency of the main pattern of Arch was significantly higher in the patient group with oral cancer than in the control group, which is in line with the present study [3,[20][21][22].
In some studies, the frequency of Whorl main pattern  [13].
In the study by Vinothini et al. [17] as well as David et al. [20], the frequency of the Loop major pattern was significantly higher in the patient group than in the control; the results of these studies were incongruent with ours [17,20].
Based on the results of Ganvir et al. [24] as well as Patil et al. [25], the frequency of Whorl major pattern in the experimental group was significantly higher than in the control; on the other hand, the frequency of Loop major pattern in the study by Ganvir and Ulnar Loop soft pattern in the study by Patil was significantly higher in the control group than in the experimental group. In the present study, the frequency of these two major types of fingerprint did not differ significantly between the two groups, which are inconsistent with these mentioned studies [24][25].
Based on the analyses of this study, in both experimental and control groups, the maximum frequency belongs to Ulnar Loop followed by Simple Whorl, which is in line with the findings of Ghosh et al. [26].
One of the reasons for the differences across these studies is the study population because it has been stated that fingerprint patterns are different across different races and communities. Since in these studies, the race of the subjects has not been mentioned, these differences can be attributed to this issue and should be considered before employing the results in clinical practice [25].

Conclusion
Since dermatoglyphics is contingent upon genetic variations and as in most malignancies both genetic and environmental factors are involved, fingerprint can be used for investigating the susceptibility of people in developing different diseases, though further studies are required in this regard. This method is in no way a substitute for gold standard methods for diagnosis. Nevertheless, dermatoglyphic can be used as a helpful index in order to identifying susceptible populations and scheduling screening and preventive programs, which is capable to decrease the rate of OSCC.